Mr. Obama accepted Ms. Sebelius’s resignation this week, and on Friday morning he will nominate Sylvia Mathews Burwell, the director of the Office of Management and Budget, to replace her, officials said.

The departure comes as the Obama administration tries to move beyond its early stumbles in carrying out the law, persuade a still-skeptical public of its lasting benefits, and help Democratic incumbents, who face blistering attack ads after supporting the legislation, survive the midterm elections this fall.

Officials said Ms. Sebelius, 65, made the decision to resign and was not forced out. But the frustration at the White House over her performance had become increasingly clear, as administration aides worried that the crippling problems at HealthCare.gov, the website set up to enroll Americans in insurance exchanges, would result in lasting damage to the president’s legacy.

Even last week, as Mr. Obama triumphantly announced that enrollments in the exchanges had exceeded seven million, she did not appear next to him for the news conference in the Rose Garden.

The president is hoping that Ms. Burwell, 48, a Harvard- and Oxford-educated West Virginia native with a background in economic policy, will bring an intense focus and management acumen to the department. The budget office, which she has overseen since April of last year, is deeply involved in developing and carrying out health care policy.

“The president wants to make sure we have a proven manager and relentless implementer in the job over there, which is why he is going to nominate Sylvia,” said Denis R. McDonough, the White House chief of staff.

Last month, Ms. Sebelius approached Mr. Obama and began a series of conversations about her future, Mr. McDonough said. The secretary told the president that the March 31 deadline for sign-ups under the health care law — and rising enrollment numbers — provided an opportunity for change, and that he would be best served by someone who was not the target of so much political ire, Mr. McDonough said.

“What was clear is that she thought that it was time to transition the leadership to somebody else,” he said. “She’s made clear in other comments publicly that she recognizes that she takes a lot of the incoming. She does hope — all of us hope — that we can get beyond the partisan sniping.”

The resignation is a low point in what had been a remarkable career for Ms. Sebelius, who as governor of Kansas was named by Time magazine as one of the five best governors in the country and was even mentioned as a possible running mate for Mr. Obama in 2008. The two had bonded when Ms. Sebelius endorsed his presidential bid early in 2008, becoming one of the highest-profile Democratic women to back him over Hillary Rodham Clinton, and helping him deliver a big win in the Kansas caucus.

White House officials were quick to point out the many successes during Ms. Sebelius’s tenure: the end to pre-existing conditions as a bar to insurance, the ability for young people to stay on their parents’ insurance, and the reduction in the growth of health care costs. In addition, Ms. Sebelius helped push through mental health parity in insurance plans and worked with the Department of Education to promote early childhood education.

Ms. Sebelius said in an interview Thursday that she always knew that she would not “be here to turn out the lights in 2017.”

“My balance has always been, when do you make that decision?” she added.

The president had been under pressure for months to fire Ms. Sebelius. But he had resisted, in part because he did not want the Department of Health and Human Services to undergo more upheaval amid all the problems plaguing HealthCare.gov, and in part because of his general reluctance to publicly rebuke top officials.

In November, Mr. Obama defended the secretary, saying in an interview with NBC News that she “doesn’t write code; yeah, she wasn’t our I.T. person.” As recently as last week, Jay Carney, the White House press secretary, rejected any suggestion that Ms. Sebelius would be fired.

Mr. McDonough on Thursday praised Ms. Sebelius as “a fierce advocate,” and said she had been “tenacious in her belief” in the president’s health care law. “She’s fearless in her defense of this idea at the heart of the Affordable Care Act,” he said. “The president has commented to me countless times how much he admires that.”

But the Affordable Care Act faces a range of obstacles, political and otherwise, in the months ahead, and Mr. Obama is hoping that Ms. Burwell can smoothly steer the department and bring stability to its operations. In addition to the midterm elections, in which the health care law is the target of a flood of negative ads, the administration is grappling with policy questions: how it will levy the penalty on individuals who lack insurance, how much premiums will increase in the coming year, and how ultimately to administer the requirement that employers provide insurance.

Ms. Sebelius was not Mr. Obama’s first choice to lead the department; he wanted former Senator Tom Daschle in the job, but Mr. Daschle withdrew after acknowledging that he had underpaid his taxes for several years. She was hailed as a gifted political leader in Kansas who could work with legislators of both parties, but those skills were less evident in Washington, and she became a more distant figure within the administration.

In addition to the political battles over the passage and carrying out of the Affordable Care Act, she clashed with conservatives over contraception, and faced frequent calls for her political head by Republicans after the health care website failed to function properly last year.

In hearings on Capitol Hill, Ms. Sebelius sometimes grew rattled under grillings by lawmakers. In one hearing at the end of October, Ms. Sebelius declared that HealthCare.gov “has never crashed.”

“It is functional,” she added, “but at a very slow speed and very low reliability, and has continued to function.”

She made that statement even as large screens in the hearing room showed a live shot of the website with a page that said: “The system is down at the moment. We are experiencing technical difficulties and hope to have them resolved soon.”

An appearance on “The Daily Show With Jon Stewart” last October went even worse. Mr. Stewart challenged her to “sign up for Obamacare” before he could download every movie ever made. “We’ll see which happens first,” he joked. She struggled to defend the website and the health care law.

The television appearance prompted headlines like “Kathleen Sebelius’s Daily Show Disaster” and accusations from Republicans that she was being misleading. Democrats squirmed at her stiff and halting performance, which did little to inspire confidence in the website’s performance — or her own.

But Ms. Sebelius has not been at the center of public attention in recent weeks. After the poor public performances, her national television exposure has been limited, but she has continued to make small appearances and has been active on Twitter to press for people to sign up for insurance. She submitted to another grilling before a Senate committee Thursday and later acknowledged that the idea of not doing “a hearing every three weeks sounds pretty good to me.”

The president’s choice of Ms. Burwell to lead the Department of Health and Human Services places a relative outsider at the helm of one of the government’s largest bureaucracies. Ms. Burwell has led the president’s budget office since taking over for Jacob J. Lew, who is now the Treasury secretary.

Ms. Sebelius said she hoped — but did not expect — that her departure would represent the beginning of a more cooperative period in Washington to make health care better.

“If I could take something along with me,” she said, it would be “all the animosity. If that could just leave with me, and we could get to a new chapter, that would be terrific.”

Burwell, 48, is no stranger to top-level administrative positions, having served as deputy White House chief of staff during the Clinton administration and in top roles at the Treasury Department and the National Economic Council.

She served at the Office of Management and Budget twice, as deputy director under Jack Lew from 1998 to 2001, and took over as director about a year ago. She helped the administration manage its response to a shutdown of the federal government brought on by a budget battle with Republicans in October.

In the intervening years, she worked at the Bill and Melinda Gates Foundation and as head of the Wal-Mart Foundation.

Burwell "seems to have a strong background in management, and that's what we need now," said Timothy Jost, a healthcare expert who teaches at Washington and Lee University.

While at the Bill and Melinda Gates Foundation, her program focused on combating world poverty through agricultural development, financial services for the poor, and global libraries. She was Chief Operating Officer and Executive Director of the Foundation prior to its reorganization in 2006.

She's also a Clinton administration alumnus, having served in a number of positions — handling budget matters, treasury, and others. It was Burwell who was instrumental in designing a number of the federal budgets that turned from deficits to surpluses, according to The Wall Street Journal.

She has an impressive academic record, with an A.B. from Harvard and B.A. from Oxford University where she was a Rhodes Scholar.

Still, Burwell is relatively unknown outside the White House, as one of the few actions that got her widely noticed was her ordering the first government shutdown in 17 years, NBC reports.

The West Virginia native was confirmed as budget director in April 2013 by a Senate vote of 96-0. Many Republicans saw her nomination as a potential breakthrough because she brought corporate experience to a White House often criticized for being too insular.

Ms. Burwell also was well-known for an approach that favored relationship-building over partisan battles.
.....
In recent public appearances, Ms. Burwell has rattled off volumes of data about the number of Americans who are uninsured, lack access to affordable health care, and the costs of various parts of Medicare. But, during several question and answer sessions, she has often tried to steer interviews toward explanations of the Affordable Care Act that simplify the law's basic goals.

"It is about improving access," she said at a recent event, hosted by The Atlantic magazine. "It is about improving the quality of health care."
.......

HHS also manages two large entitlement programs, Medicare, a government-run health care program for nearly 50 million mostly older Americans, and Medicaid, a health-care program run jointly by states and the federal government, which offers health care to those with low incomes.

The White House and congressional Republicans, particularly Mr. Ryan, are at odds about how these costly, expansive programs should be designed, and they remain a constant source of friction heading into the midterm elections.

Ms. Burwell has signaled, though, that changes to these programs might be achievable if there can be a bipartisan agreement, acknowledging their projected future costs. At the recent Senate hearing, she said the health care space represents "one of the fundamental drivers of the deficit."

CNN) -- Kathleen Sebelius -- who weathered heavy criticism over the flaw-filled launch of the Obamacare website, then saw the program through as it topped a major milestone -- is resigning as secretary of the Department of Health and Human Services, a White House official said Thursday.

President Barack Obama intends to nominate Sylvia Mathews Burwell, current director of the Office of Management and Budget, to replace Sebelius, according to the official.

A former Kansas governor and, before that, state insurance commissioner, Sebelius was sworn in as HHS secretary in April 2009.

Her time as head of the federal health agency coincided with the passage and implementation of the Affordable Care Act, the bill often referred to as Obamacare.

Sebelius came under fire last fall for the rocky rollout ofHealthCare.gov, the website central to the new law's implementation.

That included being subject of a "Saturday Night Live" parody and talk show one-liners panning her. Republicans in Congress were especially critical of what they saw as her lack of leadership shepherding through what they saw as an ill-conceived, ill-advised law. Wyoming Sen. John Barrasso went so far as to characterize her last October as the "laughingstock of America."

But Sebelius, 65, held on to her job, insisting America shouldn't abandon the legislation and all that it hopes to achieve.

"There are people in this country who have waited for decades for affordable health coverage for themselves and their families," Sebelius said, explaining why the website's launch wasn't pushed back despite anticipated problems. "...So waiting is not really an option."

The website's performance did improve significantly, prompting the calls for her job to die down as well. Earlier this month, in a letter to department employees, Sebelius reflected on Obamacare enrollment exceeding its target of 7 million as evidence of "the progress we've made, together," while stating "our work is far from over."

"I know that this law has been at the center of much debate and discourse in Washington, but what this enrollment demonstrates is that the Affordable Care Act is working and much needed," she said in the note.

According to senior Obama administration officials, Sebelius told the President in early March that she thought the enrollment period would end well and, after that, she planned to step down. Even granted the initial uproar over the website, her decision to resign was on her own accord, the officials said.

One White House official praised her overseeing "one of the most consequential initiatives of this administration" as well as her efforts to "improve children's health, expand mental health care, reduce racial and ethnic disparities, bring us closer to the first AIDS-free generation and promote women's health."

"The President is deeply grateful for her service," the official said.

House Majority Leader Eric Cantor, a Virginia Republican, thanked Sebelius for her five years in the federal government -- while taking at a swipe at the legislation she is most closely associated with.

"She had an impossible task: nobody can make Obamacare work,"Cantor tweeted.

Other Republicans weren't that gracious. Rep. Marsha Blackburn of Tennessee said Sebelius' departure "has been a long time coming after a litany of failures and total mismanagement."

Not surprisingly, given the sharp partisan divide that defines the Obamacare debate, Democrats came to her support. House Minority Leader Nancy Pelosi commended the outgoing health secretary for her dedication "to a single purpose: to make health care a right, not a privilege, for all Americans."

Sebelius is expected to be by the President's side at 11 a.m. Friday when he announces Burwell's nomination, according to a White House official.

Burwell, 48, was confirmed to her current Cabinet-rank position in April 2013. She came to the White House from her spot atop the Walmart Foundation -- the giant retail chain's charitable organization which, according to its website, donated nearly $1 billion to causes worldwide in 2011.

Prior to that, Burwell worked for the Bill and Melinda Gates Foundation and in President Bill Clinton's administration under then-Treasury Secretary Robert Rubin.

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ETA: I was merged ! Looks like I missed Justin's earlier post. Oh well. Always good to see the different stories . And a big story this is !

aside: It would be nice if they would mention that these programs can be essential to disabled people and not refer to government-issue disability insurance and retirement insurance (Medicare) and safety net (Medicaid) as "entitlement" programs.

aside: It would be nice if they would mention that these programs can be essential to disabled people and not refer to government-issue disability insurance and retirement insurance (Medicare) and safety net (Medicaid) as "entitlement" programs.

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It looks like "entitlement" terminology comes from the Wall Street Journal, which is fairly conservative. Hence they're pro-business and somewhat anti-tax, which leads to a certain outlook regarding benefits for the poor or disabled.

aside: It would be nice if they would mention that these programs can be essential to disabled people and not refer to government-issue disability insurance and retirement insurance (Medicare) and safety net (Medicaid) as "entitlement" programs.

After Ms Burwell is settled in, it would be great timing if we the community welcomed her. We could introduce her to our illness, the CFSAC, and definitely mention how President Obama has shown special interest in our cause!

I'm too sick to volunteer but hope others will be able to put something together.

"Entitlement" means/designates that a (qualifying) individual is legally entitled to (has a legal right to) x social service(s) within y geographical area(s).

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Unfortunately it's usually used in a derogatory manner by certain news organizations and politicians in the US, in an attempt to portray the receivers of benefits as strident children yelling "gimme gimme gimme, I'm entitled to everything!"

This video clip from the Press Conference is missing an important part of a quote that is on display at the Hubert Humphrey building in Washington D.C. Here is the complete quote -

"The moral test of a government is how it treats those who are at the dawn of life, the children; those who are in the twilight of life, the aged; and those who are in the shadow of life, the sick, the needy, and the handicapped."

Apparently, the portion of the quote which defined those who are in the "shadow of life" as the "sick, the needy, and the handicapped" was left out of either the video clip of the speech by Sebelius or her actual speech.

Hopefully, someone in the United States Government will understand that the treatment of those who are easily forgotten in the "shadow of life" is a moral testament as to how they are performing their jobs. With an opportunity for a new director and a new direction at the HHS, perhaps there will be an opportunity for those with oversight of this behemoth governmental agency to reflect upon the words of Hubert Humphrey and to realize the moral failing that has been perpetuated for over thirty years on those suffering from a devastating illness buried beneath a name called "Chronic Fatigue Syndrome" (C.F.S.).

This video clip from the Press Conference is missing an important part of a quote that is on display at the Hubert Humphrey building in Washington D.C. Here is the complete quote -

"The moral test of a government is how it treats those who are at the dawn of life, the children; those who are in the twilight of life, the aged; and those who are in the shadow of life, the sick, the needy, and the handicapped."

Apparently, the portion of the quote which defined those who are in the "shadow of life" as the "sick, the needy, and the handicapped" was left out of either the video clip of the speech by Sebelius or her actual speech.

Hopefully, someone in the United States Government will understand that the treatment of those who are easily forgotten in the "shadow of life" is a moral testament as to how they are performing their jobs. With an opportunity for a new director and a new direction at the HHS, perhaps there will be an opportunity for those with oversight of this behemoth governmental agency to reflect upon the words of Hubert Humphrey and to realize the moral failing that has been perpetuated for over thirty years on those suffering from a devastating illness buried beneath a name called "Chronic Fatigue Syndrome" (C.F.S.).